Indian Journal of Dermatology
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Year : 2015  |  Volume : 60  |  Issue : 1  |  Page : 99-100
Numerous asymptomatic papulo-nodules and plaques in a young male

Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India

Date of Web Publication26-Dec-2014

Correspondence Address:
Anupam Das
"Prerana", 19 Phoolbagan, Kolkata - 700 086, West Bengal
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0019-5154.147823

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How to cite this article:
Das D, Das A, Saha A, Sardar S, Shome K, Gharami RC. Numerous asymptomatic papulo-nodules and plaques in a young male. Indian J Dermatol 2015;60:99-100

How to cite this URL:
Das D, Das A, Saha A, Sardar S, Shome K, Gharami RC. Numerous asymptomatic papulo-nodules and plaques in a young male. Indian J Dermatol [serial online] 2015 [cited 2023 Jun 3];60:99-100. Available from:

A 16-year-old boy born of non-consanguineous marriage presented with numerous solid elevated lesions over his body. To start with, the lesions were asymptomatic flesh-colored papules over the face 1 year back and gradually, they progressed to attain the present status. Cutaneous examination revealed multiple brown-colored papules, discrete as well as confluent, yellow to brown-colored, well-circumscribed and smooth-surfaced nodules and plaques of varied sizes over face, more concentrated over the eyelids and chin, ears, neck, axillae, elbows, popliteal fossae, scrotum and oral mucosa [Figure 1], [Figure 2], [Figure 3]. Hairs, nails and teeth did not reveal any abnormality. There was no history of seizures, dysphagia, dyspnea, hoarseness of voice, blindness, increased urinary frequency, bone pain or any gastrointestinal complaints. Family history was non-contributory. Systemic examinations including ophthalmologic, oropharyngeal and otorhinolaryngological referral were done and nothing was found to be abnormal. Laboratory investigations including complete blood count, biochemistry panel, lipid profile, thyroid function tests, urinalysis, ECG, chest X-ray, and ultrasonographic studies of the abdomen were within normal limits. A skin biopsy was done from multiple sites. Histopathological examination in all the specimens showed diffuse proliferation of histiocytes, admixed with Touton giant cells, foam cells, scalloped macrophages, lymphocytes and eosinophils in the dermis [Figure 4], [Figure 5], [Figure 6]. Immunohistochemical staining for CD1a was found to be negative, whereas CD 68 and factor XIIIa were positive.
Figure 1: Multiple discrete and confluent brown-colored papules, nodules and plaques over the face and whitish papules on oral mucosa (a-c)

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Figure 2: Well-circumscribed and smooth-surfaced papulo-nodules and plaques of varied sizes on the axilla and small papules over neck and ear (a-c)

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Figure 3: Multiple discrete and confluent papulo-nodules and plaques on the upper extremity and external genitalia (a-c)

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Figure 4: Photomicrograph showing acanthosis and a dermal lesion composed of massive infiltration (H and E, ×10)

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Figure 5: Photomicrograph showing a dermal lesion composed of sheets of scalloped macrophages (arrow) and histiocytes (H and E, ×40)

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Figure 6: Photomicrograph showing foam cells (arrow a), Touton giant cells (arrow b), lymphocytes and eosinophils (H and E, ×40)

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What is the diagnosis?

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   References Top

Ghorpade A. Xanthoma disseminatum with koebnerized pearly penile lesions in an Indian man. Int J Dermatol. 2009;48:996‑8.  Back to cited text no. 1
Mahajan VK, Sharma AL, Chauhan PS, Mehta KS, Sharma V, Sharma S. Xanthoma disseminatum: A red herring xanthomatosis. Indian J Dermatol Venereol Leprol 2013;79:253‑4.  Back to cited text no. 2
[PUBMED]  Medknow Journal  
Kim JY, Jung HD, Choe YS, Lee WJ, Lee SJ, Kim do W, et al. A case of xanthoma disseminatum accentuating over the eyelids. Ann Dermatol 2010;22:353‑7.  Back to cited text no. 3
Burgdorf WH, Zelger B. The histiocytoses. In: Elder DE, Elenitsas R, Johnson BL, Murphy GF, Xu X, editors. Lever's Histopathology of the Skin. 10 th ed. Philadelphia: Lippincott Williams and Wilkins; 2009. p. 675.  Back to cited text no. 4
James WD, Berger TG, Elston DM, editors. Andrew's Diseases of the Skin: Clinical Dermatology. 11 th ed. Philadelphia, PA: Saunders Elsevier Publications; 2011. p. 710‑11.  Back to cited text no. 5
Eisendle K, Linder D, Ratzinger G, Zelger B, Philipp W, Piza H, et al. Infammation and lipid accumulation in xanthoma disseminatum: Therapeutic considerations. J Am Acad Dermatol 2008;58 Suppl 2:S47‑9.  Back to cited text no. 6
Kang TW, Kim SC. A case of xanthoma disseminatum presenting as pedunculating nodules and plaques. Korean J Dermatol 2007;45:290‑3.  Back to cited text no. 7
Savaºan S, Smith L, Scheer C, Dansey R, Abella E. Successful bone marrow transplantation for life threatening xanthogranuloma disseminatum in neurofbromatosis type‑1. Pediatr Transplant 2005;9:534‑6.  Back to cited text no. 8
Khezri F, Gibson LE, Tefferi A. Xanthoma disseminatum: Effective therapy with 2‑chlorodeoxyadenosine in a case series. Arch Dermatol 2011;147:459‑64.  Back to cited text no. 9


  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]

  [Table 1]


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